Transgender medicine is a relatively new field in health care, with only a small amount of evidence-based literature available for reference. This is especially true for the older adult population, for whom most information must be extrapolated from younger adults. Be it a newly transitioned older adult or a transgendered individual who has been undergoing hormonal therapy for many years, it is important that healthcare professionals be aware of the significant effects that transgender pharmacotherapy can have on older adults. Healthcare providers must also recommend appropriate preventative screenings to transgendered persons.
Objective. To assess whether the Jellybean Polypharmacy Simulation Exercise (JPSE) improved empathy in pharmacy students. Methods. The JPSE was given to all third-professional year pharmacy students in a required Special Populations course with pre-and post-scores on the Kiersma-Chen Empathy Scale (KCES) assessed, and open-ended questions on lessons learned from the exercise. Results. Pharmacy students showed a statistically significant increase in KCES scores after completing the JPSE. Open-ended question responses reflected personal growth and appreciation for patients managing difficult medication regimens. Conclusion. This polypharmacy simulation showed the ability to increase empathy in pharmacy students, as well as mimic a realistic experience in managing a multi-drug, multi-dose medication regimen.Keywords: polypharmacy, simulation, empathy INTRODUCTIONThe ability to empathize is an essential element of the health care provider-patient relationship, yet is difficult to assess formally. [1][2][3] Empathy is a core element of improving patient outcomes and has been shown to decrease the potential for litigation in the medical literature. [4][5][6][7][8] Empathy is enhanced through experiences in which an individual has the opportunity to view a situation from the perspective of another. The demographics of the pharmacy student body evaluated was different in average age and in overall health status as compared to those of the patient population represented by this exercise. It is this difference in life experience that offers an opportunity for a simulated activity to have value for inculcating empathy. With the aging of America, and the dependence of our nation's seniors on complex medication regimens for the care of chronic conditions, it is imperative for health professionals not only to understand what polypharmacy is, but how it feels. 9Given the potential impact of age and health discordance between the pharmacy learner and patient, the use of a simulated polypharmacy exercise could be an important tool for increasing the learner's empathy for those managing complex medication regimens. The Jellybean Polypharmacy Simulation Exercise (JPSE) was developed as a way to inculcate empathy for those managing multi-drug, multi-dose regimens on a daily basis. The JPSE is an eight-"prescription" regimen students manage for 7 consecutive days. This regimen includes varied dosing schedules, a drug-drug interaction that needs to be mitigated by a 2-hour separation, and meal-time dosing considerations.While multi-drug simulation exercises are not new to pharmacy education, research has focused on the ability of students to adhere to a complex regimen.10-13 Researchers have also attempted to assess the impact of interventions on empathy within simulation education; however, there is no research to date on the impact of a polypharmacy simulation on empathy using a validated empathy scale.14 The objective of this study was to determine the effectiveness of the JPSE to inculcate student METHODSAll third-year pharmacy...
Pain is highly prevalent, costly, and disabling in later life, especially when undertreated. In this article, we aim to describe the risks and benefits of non-opioid medication options for the management of pain in adults aged 65 years and older in order to provide additional options in a practitioner's tool box when designing a pain management regimen for an older adult. Non-opiate pharmacologic therapies, such as acetaminophen, nonsteroidal anti-inflammatory drugs, topicals, and antidepressants have an important role in pain management of older adults. When designing a pain regimen, taking an individualized approach that considers the patient's functional status, comorbidities, and treatment goals will maximize pain management.
The use of ChEIs may increase the risk of COPD exacerbation in the first 90 days of therapy in patients with dementia and COPD. This finding is clinically significant as previous studies have indicated no risk.
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